CMS Price Transparency Data

Group therapy session

Facility: Jeff Davis Hospital

Billing Code: 90853 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90853
Insurance Median: $256
Cash Discount Price: $114
vs. Medicare Baseline: 2.47x Medicare

The contracted insurance negotiated median rate for a Group therapy session at Jeff Davis Hospital is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $103.79, this hospital’s rate is 2.47x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$103.79

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $103.79 (100%)

Cash / Self-Pay: $114 (110%)

Insurance Median: $256 (247%)

Cash: $114 (110% of Medicare)

Ins. Median: $256 (247% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $103.79 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Pen_Network	$37	36%
Medicaid / KanCare	$64 - $175	62%
Humana	$65 - $277	63%
Peach_State	$65	63%
Wellcare	$65	63%
Medicare (plans)	$101 - $102	97%
Blue Cross Blue Shield	$103 - $244	99%
Care_Improvement_Plus	$103	99%
Coventry_Hmo	$228	220%
Coventry_Pos	$228	220%
Coventry_Ppo	$251	242%
Beech_Street	$261	251%
Care_Source	$261	251%
Cigna	$261	251%
One_Health_Ppo	$261	251%
Choicecare	$277	267%
Community_Care_Network	$277	267%
Georgia_Hospital_Network	$277	267%
Industry_Buying_Group	$277	267%
Novanet	$277	267%
Principal_Health_Care_Of_Georgia	$277	267%
Three_Rivers_Provider_Network	$277	267%
Usa_Managed_Care	$277	267%
Memorial_Health_Partners	$293	282%
Tricare	$303	292%
Multiplan	$310	299%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $114.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90853.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Jeff Davis Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90853.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.